Evaluating Students’ Use of Therapeutic Communication in Entry-Level Education: The Observer Version of the Clinical Assessment of Modes (CAM–Observer)

Abstract

Abstract Importance: The Intentional Relationship Model (IRM) guides learning about therapeutic use of self. The observer version of the Clinical Assessment of Modes (CAM–Observer) may be used to evaluate students’ therapeutic communication as the process is defined in the IRM. Objective: To assess the structural validity of the CAM–Observer. Design: Cross-sectional, psychometric study. Setting: Master’s in occupational therapy program. Participants: One hundred thirty-four entry-level students. Outcomes and Measures: The overall CAM–Observer and the individual subscales (Advocating, Collaborating, Empathizing, Encouraging, Instructing, Problem-Solving) were used to assess students’ communication from the instructor’s perspective. Results: The overall CAM–Observer and six subscales demonstrated appropriate rating scale functioning and dimensionality. The Advocating subscale demonstrated poor item fit, floor effects, and low person separation. One Collaborating item demonstrated poor fit to the overall CAM–Observer and the Collaborating subscale, requiring revision. Instructing and Encouraging items were most likely to be endorsed by the instructor–observers, resulting in a ceiling effect for the Instructing and Encouraging subscales. The Advocating and Problem-Solving items were least likely to be endorsed by the instructor–observers. Except for the Problem-Solving subscale, the overall CAM–Observer and the individual subscales could reliably separate items according to difficulty. Except for the Advocating subscale, the overall CAM–Observer and the individual subscales could reliably separate people into high- and low-performance groups. Conclusions and Relevance: The CAM–Observer offers a structurally valid and theoretically grounded assessment of students’ therapeutic communication as the process is defined in the IRM. The CAM–Observer can be integrated into occupational therapy education to guide students’ critical reflection on their interpersonal communication. What This Article Adds: The CAM–Observer offers a means of evaluating students’ therapeutic use of self.